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Alcoholism, Suicide, and Mental Illness: W.D. Mich.

03-20-2018, 11:45 AM

In a recent case from Michigan, the Plaintiff appealed his denial of LTD benefits. By way of background:

On April 15, 2013, Plaintiff, after having “a few drinks,” fell and suffered a head injury which required hospitalization. Plaintiff subsequently returned to work, but again attempted suicide on September 15, 2013. Shortly thereafter, Plaintiff submitted a disability claim pursuant to a group long term disability policy issued by Defendant (hereinafter “the Policy”). Plaintiff alleged that due to a hearing-related injury suffered as a result of his April 15, 2013 injury, he was no longer able to perform his duties as an anesthesiologist. Defendant paid Plaintiff disability benefits for a period of time after which it terminated Plaintiff’s benefits pursuant to a policy provision that limits disability benefits “due to mental illness” to twenty-four (24) months. Plaintiff’s appeal of this determination was rejected by Defendant prompting the present action.

The case proceeds strangely from there. The Plaintiff is an anesthesiologist who claims to be unable to return to work due to severe depression, balance difficulties, and an inability to be exposed to loud noises. However, the Plaintiff copes with his alcoholism and depression by racing sports cars and motorcycles. The Plaintiff also refused to make himself available for an IME, which the court took issue with as follows:

Finally, it must be noted that Defendant’s inability to secure an in-person IME of Plaintiff, is wholly attributable to Plaintiff’s refusal to travel for such, despite being fully able to undertake a motorcycle trip covering several hundred miles, as well as his insistence that any such examination be recorded despite articulating no reasonable grounds for requesting such.

Ultimately, and unsurprisingly, the court denied the Plaintiff's claim. The entire opinion is attached below.